卡莫司汀 (BCNU)、依托泊苷、阿糖胞苷和美法仑 (BEAM) 是广泛用于淋巴恶性肿瘤自体干细胞移植 (ASCT) 的高剂量化疗方案。在 BCNU 短缺期间，一些中心改用福莫司汀替代品 BEAM (FEAM)。中性粒细胞减少性小肠结肠炎（NEC）是与强化化疗相关的肠粘膜损伤后发生的危及生命的并发症。 NEC死亡率可能高达30%-50%。在我们的研究中，我们比较了 BEAM 组和 FEAM 组的 NEC 发生率、症状、死亡率和移植结果的总生存期 (OS) 和无进展生存期 (PFS)。此外，我们还比较了经历 NEC 发作 (NECe) 的患者与未经历 NEC 发作 (NECe) 的患者的住院费用。本研究共有 191 名患者入组（N = 129 例和 N = 62 例接受 BEAM 和 FEAM 调节） ， 分别）。所有患者均接受床边高分辨率超声 (US) 进行 NEC 诊断。BEAM 组和 FEAM 组的 NEC 发生率和 NEC 相关死亡率相似（31% 和 40.3%，p = 0.653，以及 5% 和 8%， p = 0.627，分别）。在中位随访 116 个月时，BEAM 组与 FEAM 组在 OS 和 PFS 方面没有差异（分别为 p = 0.181 和 p = 0.978）。在 NEC 发生率和疗效方面，BEAM 与 FEAM 相当。 NEC的高发病率和低死亡率与超声的及时诊断和及时治疗有关。美国对 NEC 诊断的了解使得 NECpos 患者与 NECneg 患者的住院天数具有可比性。还进行了 NECpos 与 NECneg 的成本分析。版权所有 © 2024 Benedetti、Traverso、Pucci、Morganti、Bramanti、Cavallo、Capochiani、De Maria、Ricchiuto、Stella 和 Galimberti。

Carmustine (BCNU), etoposide, cytarabine, and melphalan (BEAM) are a widely used high-dose chemotherapy regimen for autologous stem cell transplantation transplant (ASCT) in lymphoid malignancies. During BCNU shortages, some centers switched to fotemustine-substituted BEAM (FEAM). Neutropenic enterocolitis (NEC) is a life-threatening complication occurring after intestinal mucosa damage related to intensive chemotherapy. NEC mortality may be up to 30%-50%. In our study, we compared NEC incidence, symptoms, mortality, and transplant outcome in terms of overall survival (OS) and progression-free survival (PFS) in the BEAM vs. FEAM groups. Furthermore, we compared the cost of hospitalization of patients who did vs. patients who did not experience a NEC episode (NECe).A total of 191 patients were enrolled in this study (N = 129 and N = 62 were conditioned with BEAM and FEAM, respectively). All patients received bed-side high-resolution ultrasound (US) for NEC diagnosis.NEC incidence and NEC-related mortality were similar in the BEAM and FEAM groups (31% and 40.3%, p = 0.653, and 5% and 8%, p = 0.627, respectively). At a median follow-up of 116 months, no difference was noted between BEAM vs. FEAM groups in terms of OS and PFS (p = 0.181 and p = 0.978, respectively). BEAM appeared equivalent to FEAM in terms of NEC incidence and efficacy. The high incidence of NEC and the low mortality is related to a timely US diagnosis and prompt treatment. US knowledge in NEC diagnosis allows to have comparable days of hospitalization of patients NECpos vs. patients NECneg. The cost analysis of NECpos vs. NECneg has been also performed.Copyright © 2024 Benedetti, Traverso, Pucci, Morganti, Bramanti, Cavallo, Capochiani, De Maria, Ricchiuto, Stella and Galimberti.